Epidemiology of herpes simplex virus type 2 in Latin America and the Caribbean: systematic review, meta-analyses and metaregressions

• Published in: Sexually transmitted infections Vol. 97; no. 7; pp. 490 - 500
• Main Authors: Harfouche, Manale, Maalmi, Haifa, Abu-Raddad, Laith J
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.11.2021; BMJ Publishing Group LTD; BMJ Publishing Group
• Subjects: Acquired immune deficiency syndrome; Age groups; AIDS; Antibodies; Citation management software; Data collection; Epidemiology; genital herpes; Herpes Genitalis; Herpes Simplex; Herpes viruses; Infections; Meta-analysis; Population; Response rates; Review; Sample size; seroprevalence; Systematic review; Ulcers; Qatar; Latin America
• ISSN: 1368-4973; 1472-3263
• DOI: 10.1136/sextrans-2021-054972

ObjectiveTo characterise epidemiology of herpes simplex virus type 2 (HSV-2) in Latin America and the Caribbean.MethodsHSV-2 reports were systematically reviewed and synthesised, and findings were reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Meta-analyses and metaregressions were conducted.Finding102 relevant reports were identified including 13 overall incidence measures, 163 overall (and 402 stratified) seroprevalence measures, and 7 and 10 proportions of virus detection in genital ulcer disease and in genital herpes, respectively. Pooled mean seroprevalence was 20.6% (95% CI 18.7% to 22.5%) in general populations, 33.3% (95% CI 26.0% to 41.0%) in intermediate-risk populations, 74.8% (95% CI 70.6% to 78.8%) in female sex workers, and 54.6% (95% CI 47.4% to 61.7%) in male sex workers, men who have sex with men and transgender people. In general populations, seroprevalence increased from 9.6% (95% CI 7.1% to 12.4%) in those aged <20 years to 17.9% (95% CI 13.6% to 22.5%) in those aged 20–30, 27.6% (95% CI 21.4% to 34.2%) in those aged 30–40 and 38.4% (95% CI 32.8% to 44.2%) in those aged >40. Compared with women, men had lower seroprevalence with an adjusted risk ratio (ARR) of 0.68 (95% CI 0.60 to 0.76). Seroprevalence declined by 2% per year over the last three decades (ARR of 0.98, 95% CI 0.97 to 0.99). Pooled mean proportions of HSV-2 detection in GUD and genital herpes were 41.4% (95% CI 18.9% to 67.0%) and 91.1% (95% CI 82.7% to 97.2%), respectively.ConclusionsOne in five adults is HSV-2 infected, a higher level than other world regions, but seroprevalence is declining. Despite this decline, HSV-2 persists as the aetiological cause of nearly half of GUD cases and almost all of genital herpes cases.